The association between hepatobiliary system pathology and oral cavity status
DOI:
https://doi.org/10.14739/2310-1210.2026.1.338997Keywords:
hepatobiliary diseases, dental caries, periodontitis, diseases of oral cavity mucusAbstract
Aim: to determine the relationship between hepatobiliary system (HBS) pathology and oral health status based on a synthesis of professional literature.
Materials and methods. A bibliosemantic analysis was performed on research results from Ukrainian and international professional literature indexed in PubMed, Scopus, Web of Science, and Google Scholar. The search utilized keywords: hepatobiliary system, liver diseases, biliary tract diseases, dental caries, periodontitis, and oral mucosal diseases.
Results. The study indicates that pathological changes in the hepatobiliary complex disrupt numerous vital systemic processes. Existing research has explored the development of hepatorenal, hepatoencephalic, hepatopulmonary, dermatological, and cardiovascular syndromes associated with HBS pathology. The authors have identified a significant influence of hepatobiliary diseases on the development of oral conditions, specifically affecting the periodontium, oral mucosa, salivary glands, and dental hard tissues. Furthermore, periodontitis is increasingly recognized as a risk factor that may contribute to the progression of hepatobiliary pathology. Evidence confirms a bidirectional correlation between HBS disorders and oral tissue health.
Conclusions. Impairment of hepatic metabolic functions, including protein synthesis, accumulation, and distribution, as well as hormone and vitamin regulation and the activation of pro-inflammatory processes, negatively impacts various organ systems. It has been established that microbiome alterations observed in periodontitis play a significant role in the pathogenesis of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Hepatobiliary pathology impairs the regeneration of both connective tissue and bone structures within the oral cavity. Clinical and experimental data also confirm that viral hepatitis is frequently accompanied by pathological changes in the salivary glands.
References
Stepanov Y, Skirda I, Petishko O. [Digestive system diseases: the actual problem of clinical medicine]. Gastroenterology. 2019;53(1):1-6. Ukrainian. doi: https://doi.org/10.22141/2308-2097.53.1.2019.163450
Filippova A. [Diseases of the hepatobiliary system: focus on rational hepatotropic therapy]. Gastroenterology. 2019;53(3):188-95. Ukrainian. doi: https://doi.org/10.22141/2308-2097.53.3.2019.182866
Si-Tayeb K, Lemaigre FP, Duncan SA. Organogenesis and development of the liver. Dev Cell. 2010;18(2):175-89. doi: https://doi.org/10.1016/j.devcel.2010.01.011
Chiriac S, Stanciu C, Girleanu I, Cojocariu C, Sfarti C, Singeap AM, et al. Nonalcoholic Fatty Liver Disease and Cardiovascular Diseases: The Heart of the Matter. Can J Gastroenterol Hepatol. 2021;2021:6696857. doi: https://doi.org/10.1155/2021/6696857
Duell PB, Welty FK, Miller M, Chait A, Hammond G, Ahmad Z, et al. Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol. 2022;42(6):e168-e185. doi: https://doi.org/10.1161/ATV.0000000000000153
Pilat IO, Skrypnyk IM. [Impact of coronary artery disease on steatotic liver disease progression]. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 2024;24(2):44-8. Ukrainian. doi: https://doi.org/10.31718/2077-1096.24.2.44
Abdallah LR, de Matos RC, E Souza YP, Vieira-Soares D, Muller-Machado G, Pollo-Flores P. Non-alcoholic Fatty Liver Disease and Its Links with Inflammation and Atherosclerosis. Curr Atheroscler Rep. 2020;22(1):7. doi: https://doi.org/10.1007/s11883-020-0820-8
Bentsa TM. [Non-alcoholic fatty liver disease and cardiovascular diseases: features of the comorbid course]. Medicine of Ukraine. 2020;237(1):44-7. Ukrainian. doi: https://doi.org/10.37987/1997-9894.2020.1(237).214176
Krynytska IY, Marushchak MI. [The indices of nitrogen (II) oxide system in experimental hepatopulmonary syndrome]. Ukrainian Biochemical Journal. 2018;90(5):91-7. Ukrainian. doi: https://doi.org/10.15407/ubj90.05.091
Abrahamovych OO, Abrahamovych MO, Tolopko SY, Ferko MR. [Hepatopulmonary syndrome: ventilative-perfusion lung function, pathogenesis of its disorders]. Tuberculosis. Lung diseases. HIV infection. 2013;13(2):52-8. Ukrainian.
Chooklin SM, Chuklin SS, Posivnych MM, Krystopchuk SA. [Pathophysiological basis of hepatopulmonary syndrome]. Gastroenterology. 2024;58(1):73-81. Ukrainian. doi: https://doi.org/10.22141/2308-2097.58.1.2024.590
Manzhalii E. [Hepatorenal syndrome. Differentiated approach to treatment]. Aktualni problemy nefrolohii. 2021;14(29):21-8. Ukrainian. doi: https://doi.org/10.37321/nefrology.2021.29-02
Chooklin S. [Hepatorenal syndrome: recent developments in pathophysiology]. Naukovyi visnyk Uzhhorodskoho universytetu. Seriia "Medytsyna". 2009;36:48-54. Ukrainian. Available from: http://nbuv.gov.ua/UJRN/UNUMED_2009_36_46
Marushchak M, Kirichek N, ZaetsT, Lisnyanska N. [Epidemiology of hepatorenal syndrome: current data]. Health & Education. 2023(4):34-40. Ukrainian. doi: https://doi.org/10.32782/health-2023.4.6
Hopp AE, Dirks M, Petrusch C, Goldbecker A, Tryc AB, Barg-Hock H, et al. Hepatic Encephalopathy Is Reversible in the Long Term After Liver Transplantation. Liver Transpl. 2019;25(11):1661-72. doi: https://doi.org/10.1002/lt.25626
Saleh ZM, Solano QP, Louissaint J, Jepsen P, Tapper EB. The incidence and outcome of postoperative hepatic encephalopathy in patients with cirrhosis. United European Gastroenterol J. 2021;9(6):672-80. doi: https://doi.org/10.1002/ueg2.12104
Tovazhnyanska OL, Rafalska NS. [Clinical-neuropsychological features of the hepatic encephalopathy formation]. Psychiatry, neurology and medical psychology. 2019;(11):48-54. Ukrainian. doi: https://doi.org/10.26565/2312-5675-2019-11-07
Yahmur VB, Melanich SL, Nedzvetska NV. [Diagnosis of minimal hepatic encephalopathy using neuropsychometric tests]. Gastroenterology. 2015;(2.56):33-7. Ukrainian. doi: https://doi.org/10.22141/2308-2097.2.56.2015.81489
Karadag AS, Lavery MJ. Skin and the metabolic syndrome. Clin Dermatol. 2018;36(1):1-2. doi: https://doi.org/10.1016/j.clindermatol.2017.09.001
Shkilna МІ, Smachylo IV. [Prevalence of skin diseases with liver diseases: epidemiology, etiology, pathogenesism]. Bulletinof social hygiene and health protection organization of Ukraine. 2024;(3):93-8. Ukrainian. doi: https://doi.org/10.11603/1681-2786.2024.3.14955
Snast I, Dalal A, Twig G, Astman N, Kedem R, Levin D, et al. Acne and obesity: A nationwide study of 600,404 adolescents. J Am Acad Dermatol. 2019;81(3):723-9. doi: https://doi.org/10.1016/j.jaad.2019.04.009
Svan OB. Effect of acute stress on performance biliary liver function in terms of skin kriourazhennya experiment. Zdobutky klinichnoi i eksperymentalnoi medytsyny. 2015;(2-3):135-7. Ukrainian. doi: https://doi.org/10.11603/1811-2471.2015.v23.i2-3.5259
Moroz LV, Musayev E, Haiduk O, Shkondina O. [Evaluation of the vitamin D in patients with chronic hepatitis C]. Bulletin of Vinnytsia National Medical University 2017;21(2):478-80. Ukrainian. Available from: https://reports-vnmedical.com.ua/index.php/journal/article/view/33/28
Mogilevskaya TV, Makarenko OA, Gladkiy TV. [Morphometric and metabolic disorders in the bone tissue of laboratory rats with chronic toxic hepatitis]. Ukrainian Journal of Medicine, Biology and Sport. 2021;6(3):347-52. Ukrainian. doi: https://doi.org/10.26693/jmbs06.03.347
Tkachenko TV, Pentiuk NO, Pentiuk LO, Tomashkevych HI. [Osteoporosis in patients with chronic liver disease: pathogenesis, diagnosis and treatment]. Bukovinian Medical Herald. 2023;27(2):53-9. Ukrainian. doi: https://doi.org/10.24061/2413-0737.27.2.106.2023.9
Veliky M, Labudzynskyi D, Lisakovska O, Pasichna E, Ivonin S. [Coaction effect of new pyrazole-containing bisphosphonates and vitamin D3 in experimental osteoporosis]. Bulletin of Taras Shevchenko National University of Kiev. 2020;82(3):29-35. Ukrainian. doi: https://doi.org/10.17721/1728_2748.2020.82.29-35
Pan K, Tu R, Yao X, Zhu Z. Associations between serum calcium, 25(OH)D level and bone mineral density in adolescents. Adv Rheumatol. 2021;61(1):16. doi: https://doi.org/10.1186/s42358-021-00174-8
Dmukhalska YB, Korda MM, Yaroshenko TY. [The corrective effect of peptides on the pro- and antioxidant system indicators' changes in rats of different ages affected by heavy metals and glyphosate]. Medychna ta klinichna khimiia. 2024;26(2):65-74. Ukrainian. doi: https://doi.org/10.11603/mcch.2410-681X.2024.i2.14769
Levytskyi AP, Demianenko SO. Hepato-oral syndrome [Hepato-oralnyi syndrom]. Simferopol, Ukraine: Tarpan; 2012. Ukrainian.
Levytskyi AP, Demianenko SO, Tsyselskyi YuV. Antimicrobial function of the liver [Antymikrobna funktsiia pechinky]. Odesa. Ukraine: KP OHT; 2011. Ukrainian.
Hatasa M, Yoshida S, Takahashi H, Tanaka K, Kubotsu Y, Ohsugi Y, et al. Relationship between NAFLD and Periodontal Disease from the View of Clinical and Basic Research, and Immunological Response. Int J Mol Sci. 2021;22(7):3728. doi: https://doi.org/10.3390/ijms22073728
Mei EH, Yao C, Chen YN, Nan SX, Qi SC. Multifunctional role of oral bacteria in the progression of non-alcoholic fatty liver disease. World J Hepatol. 2024;16(5):688-702. doi: https://doi.org/10.4254/wjh.v16.i5.688
Alazawi W, Bernabe E, Tai D, Janicki T, Kemos P, Samsuddin S, et al. Periodontitis is associated with significant hepatic fibrosis in patients with non-alcoholic fatty liver disease. PLoS One. 2017;12(12):e0185902. doi: https://doi.org/10.1371/journal.pone.0185902
Komazaki R, Katagiri S, Takahashi H, Maekawa S, Shiba T, Takeuchi Y, et al. Periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans affect non-alcoholic fatty liver disease by altering gut microbiota and glucose metabolism. Sci Rep. 2017;7(1):13950. doi: https://doi.org/10.1038/s41598-017-14260-9. Erratum in: Sci Rep. 2018;8(1):4620. doi: https://doi.org/10.1038/s41598-018-23000-6
Liu L, Geng Y, Xiong C. Impact of Porphyromonas gingivalis-odontogenic infection on the pathogenesis of non-alcoholic fatty liver disease. Ann Med. 2023;55(2):2255825. doi: https://doi.org/10.1080/07853890.2023.2255825
Akinkugbe AA, Barritt AS, Cai J, Offenbacher S, Thyagarajan B, Khambaty T, et al. Periodontitis and prevalence of elevated aminotransferases in the Hispanic Community Health Study/Study of Latinos. J Periodontol. 2018;89(8):949-58. doi: https://doi.org/10.1002/jper.17-0579
Kuraji R, Shiba T, Dong TS, Numabe Y, Kapila YL. Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis. World J Gastroenterol. 2023;29(6):967-96. doi: https://doi.org/10.3748/wjg.v29.i6.967
Kuraji R, Sekino S, Kapila Y, Numabe Y. Periodontal disease-related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral-liver axis. Periodontol 2000. 2021;87(1):204-40. doi: https://doi.org/10.1111/prd.12387
Kobayashi T, Iwaki M, Nogami A, Honda Y, Ogawa Y, Imajo K, et al. Involvement of Periodontal Disease in the Pathogenesis and Exacerbation of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis: A Review Nutrients. 2023;15(5):1269. doi: https://doi.org/10.3390/nu15051269
Ahn JS, Yang JW, Oh SJ, Shin YY, Kang MJ, Park HR, et al. Porphyromonas gingivalis exacerbates the progression of fatty liver disease via CD36-PPARγ pathway. BMB Rep. 2021;54(6):323-8. doi: https://doi.org/10.5483/BMBRep.2021.54.6.050
Skyba VI, Shnaider SA. Strukturno-metabolichni porushennia v tkanynakh porozhnyny rotu pry hepatobiliarnii patolohii ta yikh korektsiia. Odesa. Ukraine: KP OHT; 2022.
Polishchuk SS, Skyba VY, Davydenko IS, Shuvalov SM, Gavrilyuk AO, Yakovtsova ІІ, et al. Histological changes of bone tissue in the perforation defect site of the rat mandible when using hepatoprotector in odstructive hepatitis. World of Medicine and Biology. 2020;(2):193-8. doi: https://doi.org/10.26724/2079-8334-2020-2-72-193-198
Polishchuk SS. [Pathogenetic substantiation of complex treatment of patients with injuries of maxillofacial area on the background of pathology of the hepatobiliary system (experimental and clinical study] [dissertation on the Internet]. Vinnytsya, Ukraine: National Pirogov Memorial Medical University; 2019. Ukrainain. Available from: https://nrat.ukrintei.ua/en/searchdoc/0519U000246/#
Polishchuk VS, Polishchuk SS. [Peculiarities of the course after the operative course of patients after dental implantation on the background of the pathology of the hepatobilier system]. Stomatological Bulletin. 2022;(3):51-6. Ukrainain. doi: https://doi.org/10.35220/2078-8916-2022-45-3.9
Skyba VY, Polishchuk SS, Davydenko IS, Shtatko OI, Shuvalov SM, Gavrilyuk AO, et al. [Dynamics of morphometric bone changes in the site of mandibular perforation defect in rats with toxic hepatitis and use of hepatoprotector]. World of medicine and biology. 2020;(2):198-203. Ukrainain. doi: http://dx.doi.org/10.26724/2079-8334-2020-2-72-198-203
Reynal F, Camoin A, Tardieu C, Fabre A, Blanchet I. Oral findings in children with congenital cholestatic disease: A systematic review of case reports and case series. Arch Pediatr. 2023;30(6):427-37. doi: https://doi.org/10.1016/j.arcped.2023.06.003
Sommer S, Magagnin K, Kramer PF, Tovo MF, Bervian J. Green teeth associated with neonatal hyperbilirubinemia caused by biliary atresia: review and case report. J Clin Pediatr Dent. 2010;35(2):199-202. doi: https://doi.org/10.17796/jcpd.35.2.em06x41541776004
Borys GZ. [Clinical and experimental rationale for the prevention and treatment of salivary glands diseases in patients with hepatobiliary pathology] [dissertation on the Internet]. Odessa, Ukraine: State Establishment "Institute of Stomatology and Maxillofacial Surgery National Academy of Medical Sciences of Ukraine", 2020. Ukrainain. Available from: https://nrat.ukrintei.ua/en/searchdoc/0420U100654/#
Boris GS, Furdychko AI. [Clinical rationale for using anti-dysbiotic medicine "lysozyme-forte" in the complex treatment of patients with the salivary glands diseases on the background of hepatobiliary pathology]. Innovatsii v stomatolohii. 2019;(1):12-7. Ukrainian. doi: https://doi.org/10.35220/2523-420X/2019.1.3
Levitsky AP, Boris GZ, Furdychko AI. [Clinical and laboratory substantiation of influence of the salivary glands in the dental status of patients with hepatobiliary disease]. Visnyk naukovykh doslidzhen. 2017(1):99-101. Ukrainian. doi: https://doi.org/10.11603/2415-8798.2017.1.7593
Åberg F, Helenius-Hietala J. Oral Health and Liver Disease: Bidirectional Associations-A Narrative Review. Dent J (Basel). 2022;10(2):16. doi: https://doi.org/10.3390/dj10020016
Furdychko AI, Ilchyshyn MP, Fedun IR, Barylyak AY, Slaba OM, Khoroz LM. Periodontal status in patients with diseases of hepatobiliary system, burdened with tobacco and drug addiction. Wiad Lek. 2020;73(3):517-20. doi: https://doi.org/10.36740/WLek202003121
Sichkoriz KA. [Changes of oral microbiocenosis in periodontal diseases in settings of chronic hepatitis C]. Visnyk problem biolohii i medytsyny. 2018;4(2):348-52. Ukrainian. doi: http://dx.doi.org/10.29254/2077-4214-2018-4-2-147-348-352
Liu Z, Chu A. Sjögren's Syndrome and Viral Infections. Rheumatol Ther. 2021;8(3):1051-9. doi: https://doi.org/10.1007/s40744-021-00334-8
Garg B, Arbabi A, Kirkland PA. Extrahepatic Manifestations of Chronic Hepatitis C Virus (HCV) Infection. Cureus. 2024;16(3):e57343. doi: https://doi.org/10.7759/cureus.57343
Sayiner M, Golabi P, Farhat F, Younossi ZM. Dermatologic Manifestations of Chronic Hepatitis C Infection. Clin Liver Dis. 2017;21(3):555-64. doi: https://doi.org/10.1016/j.cld.2017.03.010
Maldonado JO, Beach ME, Wang Y, Perez P, Yin H, Pelayo E, et al. HCV Infection Alters Salivary Gland Histology and Saliva Composition. J Dent Res. 2022;101(5):534-41. doi: https://doi.org/10.1177/00220345211049395
Atyeo N, Maldonado JO, Warner BM, Chiorini JA. Salivary Glands and Viral Pathogenesis. J Dent Res. 2024;103(3):227-34. doi: https://doi.org/10.1177/00220345231222871
Mahmood MK, Fatih MT, Kurda HA, Mahmood NK, Shareef FU, Faraidun H, et al. Role of viruses in periodontitis: An extensive review of herpesviruses, human immunodeficiency virus, coronavirus-19, papillomavirus and hepatitis viruses. World J Virol. 2024;13(4):99070. doi: https://doi.org/10.5501/wjv.v13.i4.99070
Chen X, Song J, Sun J, Zhang J, Chen X, Zeng C, et al. Hepatitis B infection is associated with periodontitis: the national health and nutrition examination survey (2009-2014). BMC Oral Health. 2024;24(1):815. doi: https://doi.org/10.1186/s12903-024-04489-y
Gheorghe DN, Bennardo F, Popescu DM, Nicolae FM, Ionele CM, Boldeanu MV, et al. Oral and Periodontal Implications of Hepatitis Type B and D. Current State of Knowledge and Future Perspectives. J Pers Med. 2022;12(10):1580. doi: https://doi.org/10.3390/jpm12101580
Hesterman MC, Furrer SV, Fallon BS, Weller ML. Analysis of Hepatitis D Virus in Minor Salivary Gland of Sjögren's Disease. J Dent Res. 2023;102(11):1272-9. doi: https://doi.org/10.1177/00220345231186394
Costa FO, Lages EJ, Lages EM, Cota LO. Periodontitis in individuals with liver cirrhosis: A case‐control study. J Clin Periodontol. 2019;46:991‐8. doi: https://doi.org/10.1111/jcpe.13172
Bie M, Wu P, Zhou J, Li Y, Zhao L. Periodontal health status in cirrhotic patients: a systematic review and meta-analysis. BMC Oral Health. 2023;23(1):362. doi: https://doi.org/10.1186/s12903-023-03052-5
Ohno T, Kikuchi T, Suzuki Y, Goto R, Takeuchi D, Hayashi JI, et al. Periodontitis promotes hepatocellular carcinoma in Stelic Animal model (STAM) mice. Sci Rep. 2024;14(1):17560. doi: https://doi.org/10.1038/s41598-024-68422-7
Tamaki N, Takaki A, Tomofuji T, Endo Y, Kasuyama K, Ekuni D, et al. Stage of hepatocellular carcinoma is associated with periodontitis. J Clin Periodontol. 2011;38(11):1015-20. doi: https://doi.org/10.1111/j.1600-051X.2011.01777.x
Albuquerque-Souza E, Sahingur SE. Periodontitis, chronic liver diseases, and the emerging oral-gut-liver axis. Periodontol 2000. 2022;89(1):125-41. doi: https://doi.org/10.1111/prd.12427
Di Profio B, Inoue G, Marui VC, de França BN, Romito GA, Ortega KL, et al. Periodontal status of liver transplant candidates and healthy controls. J Periodontol. 2018;89(12):1383-9. doi: https://doi.org/10.1002/JPER.17-0710
Alanzi A, Alkheder M, Qudeimat M. Oral Health Status of Kuwaiti Children with a History of Chronic Liver Disease. Med Princ Pract. 2019;28(4):341-6. doi: https://doi.org/10.1016/j.arcped.2023.06.003
Lin YT, Yang FT. Gingival enlargement in children administered cyclosporine after liver transplantation. J Periodontol. 2010;81(9):1250-5. doi: https://doi.org/10.1902/jop.2010.090743
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